AJN senior clinical editor Christine Moffa speaks with Melanie Barone and Linda Kim about their quality improvement project, which evaluated the use of serenity lounges—dedicated rooms where nurses can take workday breaks to relax and rejuvenate—and massage chairs on nurses’ anxiety, stress, and burnout.

Melanie Barone and Linda Kim, two of the authors of “Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19”

News, views, and interviews of interest to the nursing community.

Medicine

Science & Medicine

Science and Medicine

Practical Guide to Legislative Change as a Registered Nurse
1.Learn about what level of government would make the changes you want to see. Find out: is this a federal, state, or local issue?
Federal government example: Medicare and Medicaid (CMS) reimbursement rates for advanced practice nurses
State government example: Scope of practice for advanced practice nurses



 
2.Figure out WHO are the elected officials that represent you at that level of government because you are their constituent. It is their job to listen to your concerns!
Best website: https://www.usa.gov/elected-officials 

Federal legislators: One U.S. House of Representatives member (representing your congressional district, where you live in the state) and two senators (represent the entire state, not just your district)
State legislators: State house representative and state senator (typically both represent a district within your state)
Local officials:County/City Executive/Supervisor/Commissioners, etc.

3.Learn about your elected officials!

Federal legislators will have at least two offices; one in Washington, DC, and one or more within the congressional district. Each office has federal congressional staffers working to address constituents’ concerns and provide official follow-up.
A U.S. House member specifically represents your district’s needs (including you as a constituent) to Congress more so than U.S. Senators, as they represent your entire state’s needs.

4.If you are interested in a state issue, please be aware that state representatives and senators are “part-time” legislators. State legislative bodies typically meet in the first months of the year but occasionally are called back for special sessions.

This website shows upcoming state legislative schedules: https://documents.ncsl.org/wwwncsl/About-State-Legislatures/2024-sessions-calendar.pdf

5.It is important to be aware of your legislator’s committee assignments and if they serve in any kind of leadership role. Do they sit on a health committee? Are they the chair of a committee?

Committee assignments often are related to the member’s legislative areas of expertise and related to their professional background before running for elected office. 
Committees will be the first place legislative change will be introduced, debated, and voted on before coming to the full legislative body. 

6.Many organizations develop a form letter for you to send to a legislator regarding an issue or a specific bill. 

These are helpful but be aware that if you cut/paste, sign, and send, your letter will be placed in a pile with the rest; depending on the size of the pile of form letters about one issue, this will impact how much attention the office and the elected official gives to a certain topic. 
Please take 5-10 minutes to personalize the form letter with your own experiences and always make sure to include in the first sentence that you are a constituent of the elected official (and maybe if you voted for them). Talk about how the congressional district is impacted by the issue specifically.
Provide your background as a nurse and your contact information so the legislative staff may follow up with you about your experience and your expertise on the subject.


7.Reach out to nursing organizations that may already be advocating for this issue.They may have a legislative “champion” that has sponsored bills in the past and is helping to move towards progress on this issue.


Some nursing organizations are allowed to hire lobbyists, and some organizations cannot because of their tax filing statuses.
Some nursing organizations have political action committees (PACs) that raise money to impact legislation. 
Nursing organizations can come together into coalitions to move forward complex legislative issues.


8. Get to know your legislators as individuals. Often this happens by volunteering your time to help them out. 


Volunteering is easy and fun. The campaign provides you with all the training and materials. You just provide your time and enthusiasm.

Examples: Phone banking, door knocking, fundraising

“Learning the Legislative Process to Advocate for Patient Care and the Nursing Profession” with guest Emily Bell, MSN, RN, LNP, PMHNP-BC


In  this episode of The AJN Podcast, Susan O’Hara, PhD, MPH, RN, BA, EDAC, FNIHD,  discusses the role of nurses in design and the impact they make on patient care  and nurse safety.


Resources  for nurses interested in health care design:


Journals
HERD  - Health Environments Research and Design Journal -https://journals.sagepub.com/home/HER
BHAC  - Building Healthy Academic Communities Journal - https://ojs.library.osu.edu/index.php/BHAC
AJN  - American Journal of Nursing - https://journals.lww.com/ajnonline/pages/default.aspx


Conferences
HCD  Healthcare Design - https://www.hcdexpo.com
Environments  for Aging - https://environmentsforaging.com
PDC  Planning, Design, and Construction - https://www.ashe.org/education-events/pdc-summit-2024-san-diego


Organizations,  Certifications, and Other Resources
CHD  Center for Health Design - https://www.healthdesign.org  
EDAC  Evidence-Based Design Accreditation and Certification (EDAC) - https://www.healthdesign.org/certification-outreach/edac
FGI  Facility Guideline Institute FGI Guidelines  (Hospital, Outpatient, Residential) - https://fgiguidelines.org
NIHD  Nursing Institute for Healthcare Design -  https://nursingihd.com 


Phases  of Design
Architecture  Explained: The Phases of Designing and Building a Project - https://wc-studio.com/journal/2019/7/5/working-with-an-architect-understanding-phases-of-design-construction
Architectural  Design Process: A Quick Guide https://www.projectmanager.com/blog/architectural-design-process


Universities/Programs
The  Ohio State University College of Nursing, Center for Healthcare Innovation and  Leadership, Master of Healthcare Innovation - https://nursing.osu.edu/academics/masters/master-healthcare-innovation
The  Ohio State University Knowlton School of Architecture - https://knowlton.osu.edu  
New  York University, Rory Meyers College of Nursing. The Course: “The Environment  and Health of Populations” - https://nursing.nyu.edu


References
Cordoza,  M., Ulrich, R. S., Manulik, B. J., Gardiner, S. K., Fitzpatrick, P. S., Hazen,  T. M., Mirka, A., & Perkins, R. S. (2018). Impact of Nurses Taking Daily  Work Breaks in a Hospital Garden on Burnout. Am J Crit Care, 27(6), 508-512. https://doi.org/10.4037/ajcc2018131
Fawcett,  J. (2023). Thoughts About the Metaparadigm of Nursing: Contemporary Status and  Recommendations for Evolution. Nursing Science Quarterly, 36(3), 303-305. https://doi.org/10.1177/0894318423116977
Godin,  M. R., & Nasr, A. S. (2023). Assessing the Impact of a New Pediatric  Healthcare Facility on Medication Administration: A Human Factors Approach.  Journal of Nursing Administration, 53(6), 331-336. https://doi.org/10.1097/NNA.0000000000001295  
McDonald,  L. (2020). Florence Nightingale’s influence on hospital design, hospitalism,  hospital diseases, and hospital architects. In (Vol. 13, pp. 30-35): SAGE  Publications Sage CA: Los Angeles, CA.
Nightingale,  F. (1863). Notes on hospitals (3d , enl. and for the most part rewritten ed.).  Longman, Green, Longman, Roberts, and Green.
Nightingale,  F. (2015). Notes on Hospitals. Dover Publications. http://www.myilibrary.com?id=729288
Nightingale,  F., & Nursing, N. O. (1859). What it is and what it is not. Notes on  nursing.
O'Hara,  S. (2014). Planning intensive care unit design using computer simulation  modeling: optimizing integration of clinical, operational, and architectural  requirements. Critical Care Nursing Quarterly, 37(1), 67-82. 
O'Hara,  S., Klar, R. T., Patterson, E. S., Morris, N. S., Ascenzi, J., Fackler, J. C.,  & Perry, D. J. (2018). Macrocognition in the Healthcare Built Environment  (mHCBE): A Focused Ethnographic Study of "Neighborhoods" in a  Pediatric Intensive Care Unit. HERD, 11(2), 104-123. https://doi.org/10.1177/1937586717728484
Obeidat,  B., Younis, M. B., Al-Shlool, E. a., & Alzouby, A. (2022). A study of  workspace design characteristics exemplified by nurses’ satisfaction within  three intensive care units in a university hospital. HERD: Health Environments  Research & Design Journal, 15(2), 63-78. https://doi.org/10.1177/19375867211055
Stichler,  J. F. (2015). Using Magnet® as a Framework for Nurse Participation in Facility  Design. JONA: The Journal of Nursing Administration, 45(1), 11-13. https://doi.org/10.1097/NNA.0000000000000150
Ulrich,  R. S. (1984). View through a window may influence recovery from surgery.  Science, 224(4647), 420-421. https://doi.org/10.1126/science.6143402
Zamani,  Z., Joy, T., & Gobel, D. (2024). “We Have Outgrown Our Space; Our Facility  Is Old and Falling Apart”: Physical Design Implications to Address the Needs  and Priorities of a Critical Access Hospital (CAH). HERD: Health Environments  Research & Design Journal, 17(1), 306-325. https://doi.org/10.1177/19375867231188148

Designing Nurses: What Do Nurses in Design Do?



In this episode of The AJN Podcast, Kerry A. Milner, DNSc, APRN, FNP-BC, EBP-C, and Ellen Fineout-Overholt, PhD, RN, EBP-C, FNAP, FAAN discuss the role of evidence-based decision making in nursing education and patient care.
Milner and Fineout-Overholt share details on AJN’s new Evidence-Based Decision Making series, and the first article in the series, “Cultivating an Evidence-Based Decision-Making Mindset,” which can be found in the February issue and online at https://journals.lww.com/ajnonline/fulltext/2024/02000/cultivating_an_evidence_based_decision_making.20.aspx.
Below is the article’s full list of authors:
Kerry A. Milner is a professor in the Davis and Henley College of Nursing at Sacred Heart University in Fairfield, CT. Deana Hays is an associate professor at Oakland University in Rochester, MI. Susan Farus-Brown is an associate professor at the Ohio University School of Nursing in Athens. Mary C. Zonsius is an associate professor at the Rush University College of Nursing in Chicago. Ellen Fineout-Overholt is national senior director, Evidence-Based Practice & Implementation Science, at Ascension in St. Louis. Contact author: Kerry A. Milner, milnerk@sacredheart.edu.

Conversation with Kerry A. Milner, DNSc, APRN, FNP-BC, EBP-C, and Ellen Fineout-Overholt, PhD, RN, EBP-C, FNAP, FAAN


NP, entrepreneur, and professor,  Gabrielle Abelard, DNP, PMHNP, PMHCNS-BC, APRN, FNAP, FAAN, joins The AJN Podcast  and shares her business experience, wisdom, and insight on what APRNs need to  know and do before opening their own practice. 
Some questions to think about:
1. What’s your “brand”?

  2. How will you choose your practice name?

  3. Which geographical location would you choose?

  4. Will you go into business alone or take on partners?

  5. Will you take health insurance or not?

  6. What is your timeline?
And many more!
Recommended books:
Nurse Practitioner's Business  Practice and Legal Guide by Carolyn Buppert, JD, MS
The Doctor of Nursing Practice:  A Guidebook for Role Development and Professional Issues by Lisa Astalos  Chism, DNP, APRN, NCMP, FAANP
NP  Notes: Nurse Practitioner's Clinical Pocket Guide by  Ruth McCaffrey, DNP, ARNP, FNP-BC, GNP-BC, FAANP, and Humberto Reinoso, PhD,  FNP-BC, ENP-BC

Conversation with Gabrielle Abelard, DNP, PMHNP, PMHCNS-BC, APRN, FNAP, FAAN

In this episode of The AJN Podcast,  Kathleen Russell-Babin, PhD, RN, NEA-BC,  ACNS-BC, vice president of  professional practice at Inova Health System in Falls Church, VA, discusses  implementation science (IS). Russell-Babin is the lead author of the first  article in a new series for AJN, Applying Implementation Science.  The article describes how a multisite health care organization developed  a systemwide nurse-led IS Specialist program within a shared governance model. Russell-Babin  shared, “The series will take each of our first five projects across our health  care system and show concretely how we used our 10-step process or toolkit. It  will help readers to visualize the realities of the methods.”  In a discussion after the episode  was recorded, she added, “This process is not a quick fix. It is systematic and  takes time. Depending on the topic, sometimes the barriers are more than you  expect. But as Weiner and colleagues wrote, partial implementation gets partial  results and so staying with the process and using mapped strategies is worth  the effort.” The article is open access and can  be found here: https://journals.lww.com/ajnonline/fulltext/2023/12000/a_nurse_led_implementation_science_specialist.22.aspx. Follow  us through the series and learn how your organization can use implementation  science to promote evidence-based practice and improve patient care.

Melanie Barone and Linda Kim, two of the authors of “Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19”

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